Mitochondrial medicine

Mitochondria is an organelle found in the cells of most eukaryotes and they use aerobic respiration to generate adenosine triphosphate (ATP), the source of chemical energy in the cells. Mitochondria are involved in several human disorders like cardiac dysfunction, immune deficiency, metabolic disorders, neurodegenerative disorders and chronic fatigue.  Chronic fatigue for example as can be found in cancer patients after therapy but as discussed in the last months and years also in Post/long Covid patients.

Complex and chronic illnesses which accompany a dysfunction of the mitochondria are a growing health problem.  Reasons for this could be consumption of calorie-dense foods, a modern sedentary lifestyle, increasing stress and/or chronic subclinical inflammations exacerbate the emergence of these syndromes, as well as comorbidities, which are continuously increasing.

Normally diagnoses are confirmed by muscle biopsy. There is a whole variety of such inborn mitochondrial diseases. They can practically concern every area of the mitochondrion. For pyruvate dehydrogenase alone there are several diseases of which most are passed on dominantly x-chromosomal. In addition, there are also disorders of citrate cycle, the respiratory chain or fat burning (e.g. carnitine transporter deficiency).

Acquired forms are more frequent than genetic mitochondrial diseases. For patients suffering from acquired mitochondrial diseases the analyses do not yield characteristic findings. The clinical patterns may vary considerably. Patients often complain about lack of energy, but also complaints similar to those of CFS, MCS or fibromyalgia can be observed. Acquired mitochondrial diseases are triggered by nitrosative stress, which may damage the structure and genome of mitochondria, and lack of mitochondrial co-factors like for example co-enzyme Q10, riboflavin or niacin.

In 2014 Chacko et al have described a method to test the mitochondrial function by measuring the oxygen consumptions of the cells. Determining this mitochondrial or bioenergetic health index or BHI thus takes on particular importance. Not only does it capture the state of the mitochondria, but it also enables clear statements with prognostic and diagnostic value. Testing of the BHI in the circulating mononuclear blood cells (PBMCs) represents a test for mitochondrial function under the effects of the factors described above.

Measuring the mitochondrial function, necessary cofactors for the complexes in the mitochondrial membrane and factors that inhibit mitochondrial function like nitrosative and oxidative stress could be an approach to help patients with acquired mitochondrial disease.

Sources:

1.)www.en.wikipedia.org/wiki/Mitochondrion

2.)Biovis expert information: Mitochondrial disease, 1/2012. www.biovis.de

3.) The Bioenergetic Health Index: a new concept in mitochondrial translational research. doi: 10.1042/CS20140101